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Is Personality Disorder Madness? A Qualitative Study of the perceptions of Medical Students in Somaliland

Published online by Cambridge University Press:  19 July 2023

H. R. Arisna*
Affiliation:
Psychiatry, East London NHS Foundation Trust the Centre for Understanding of Personality, DeanCross Personality Disorder Service, London, United Kingdom
J. Handuleh
Affiliation:
the Centre for Understanding of Personality, DeanCross Personality Disorder Service, London, United Kingdom Psychiatry, St Paul Hospital Millenium Medical College, Addis Ababa, Ethiopia
K. Bhui
Affiliation:
the Centre for Understanding of Personality, DeanCross Personality Disorder Service, London, United Kingdom Dept of Psychiatry & Nuffield Department of Primary Care Health Sciences Medical Sciences Division, University of Oxford, Oxford, United Kingdom
T. Lee
Affiliation:
Psychiatry, East London NHS Foundation Trust the Centre for Understanding of Personality, DeanCross Personality Disorder Service, London, United Kingdom
*
*Corresponding author.

Abstract

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Introduction

Patients with borderline personality disorder are often a challenge to the mental health system. Psychiatrists see people with BPD as manipulative, difficult to manage, annoying, unlikely to arouse sympathy, clinicians hold negative attitude towards personality disorder.

As the next generation of doctors, medical students’ perception of patients with personality disorder (PD) is critical.

Yet a systematic review of the literature shows this has not been studied.

Objectives

The study aims to identify :

1) the understanding and perception of medical students about PD

2) factors that may relate to this knowledge and perception.

Methods

A focus group discussion (FGD) was conducted with eight medical students in their sixth year at Amoud University, Somaliland.

A case vignette of a patient with typical Borderline PD symptoms was presented to stimulate discussion. Barts Explanatory Model Inventory (BEMI) was used to explore the issue.

The FGD was conducted via MS teams, recorded, transcribed, translated and thematically analysed

Results

The Medical students showed reasonably accurate knowledge regarding Borderline PD, recognising features of unstable mood, impulsiveness, and emptiness. Of note half the participants believed religious intervention would be helpful “I believe in Islam. So,basically so to some degree it could be managed in certain religious centers”. Importantly, medical students, when asked to divest of their professional identity, and to describe their personal views associated PD with madness.

Conclusions

The views of PD as ‘madness’ and that religious intervention has a role have important implications for training and service development.

The importance of a culturally sensitive training to Medical students regarding PD to match local cultural and religious views, and consideration of development of health services which are sensitive to religious practice is highlighted.

We recommend including social and cultural implications in the training of medical students to better prepare them for the complexity of managing PD.

Disclosure of Interest

None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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